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Tuesday, March 22, 2011

Cadence Julia's Birth Story

Cadence Julia's birth story (warning: very long)

Sorry I'm just now getting around to this. It's been a very long week for us. So here is the full story. I went for my 37 week check up with my OB/GYN. Actually I was 36 weeks 6 days. I'd taken my last nifedipine dose that mornign and ironically after a month of contractions I wasn't having any contractions at all. I did notice that morning that it felt like Cadence had dropped. I was feeling some pelvic and back pressure but nothing to make me feel like things had really changed significantly. I did notice that morning that I'd actually woken up without the rib pain and felt more comfortable than normal.

So I get to my appointment and they hook me up to the monitor. Cadence's heart rate was up in the 130's range and very flat. No accelerations to be seen. Kathy the nurse was concerned so she had me drink a cup of soda. Then we waited and watched. Still no real variability. So she got my doctor and I turned more up on my left side. They were both kind of shaking and poking my tummy, we were trying to get her to "wake up". I'd also noticed a lot less movement over the weekend but thought that was normal end of pregnancy stuff. She was still doing at least 10 kicks so I wasn't terribly concerned. Anyhow, my doctor was worried enough about the lack of variability to send me to L&D. He also checked my cervix and I was dilated 3-4 cm which shocked me because I hadn't had hardly any contractions that morning. So I am still not terribly worried, just a little freaked because of the dilation! I hadn't packed a bag or anything because I was pretty convinced that I wasn't in labor that morning.

So I leave the doctor office and go to L&D. I called Mike to let him know that I was going to L&D for more monitoring and I was a little nervous. I asked him to leave work and come to the hospital even though I was "pretty sure" I wasn't in labor. I think I was in denial about the situation at that point. I got to L&D and hooked up to the monitor again. Still very flat heartrate but steady in the 130's. The nurse had me drink some cold water, cranberry juice. I hadn't eaten lunch so we thought maybe some sugar or food would get her HR up again. So I ate a banana and a muffin. Still no improvement. By about 5 pm the doctor shows up again and we are starting to talk about whether to break my water and get labor going. I'd had a few contractions on the monitor but nothing regular. He shook my belly HARD and she had a HUGE deceleration. Then in the next half hour or so the decelerations continued. He ordered stat labs because of my history of low platelets. Then they brought the ultrasound machine to my room and did a bedside ultrasound. The tech was looking for what seemed like a very long time and was mumbling to my doctor things like "No points for breathing" ect. Making me really nervous! Cadence scored a 2/10 on the biophysical profile. Not good. She also hadn't really engaged in my pelvis so they were concerned about the cord coming down if my water broke. So then we started trying to decide if I could try labor with the OR set up for a "crash" c/s if needed or just go straight to a c/s. I was bawling at this point because of my traumatic almost emergency c/s when Ethan was born. We decided ultimately that labor was too dangerous given her poor BPP score and decelerations. I had written out a birth plan explaining my previous experience with my spinal not working and almost getting a c/s. So the anesthesiologist was very very good about explaining everything and trying to calm me down.

She did a great job with my spinal and almost instantly I felt my legs go numb. My OB pinched me really hard with the clamps and I felt nothing. OMG so relieved at that point. I was still crying from nerves. Mike was right by me the whole time and I just tried to focus on him while they worked. I know it was just minutes but it felt like forever. Finally she was out. I heard my doctor say "It's a girl!!" and then I heard her screaming immediately. Such a relief.

Cadence Julia Pena was born on March 8th at 9:01 pm. Weighing 5 lbs 6 oz and 18 inches long.

There was meconium in my amniotic fluid so she was definately in distress. We don't know why yet. Her cord was small and my placenta looked "unhealthy" per my doctor. It was sent to pathology so I'm hoping to get some answers in the next week or so.

Her apgars were 8 and 9 and she was doing pretty good initially. They brought her to me for a second and I gave her little cheek a kiss. Mike left to the nursery to take pictures while they weighed her. It seemed like forever while they stitched me up. My platelets were pretty low but luckily the bleeding wasn't an issue, my doctor said I clotted off really well. They wheeled me back to my room and I waited for them to bring the baby to me.

Finally the nurse came in and said they would be keeping Cadence in the nursery overnight because her blood sugar was low and she needed oxygen. I cried because this wasn't what I had planned. I was to numb to be able to get out of bed to see her. So I waited for feeling to come back to my legs... but they did a really good job on the spinal. My legs were dead numb! My friends came in and distracted me for awhile. Around midnight my friends had all left and Mike and i were sitting there when my nurse came in. She was crying!!! So my heart was in my throat. She said that she didn't know exactly what was wrong but that they were working on Cadence. What?!?! I was sobbing. Still to numb to get out of bed and go see... I told Mike to get down there NOW and see. So my nurse stayed with me trying to say reassuring things while I just layed there and sobbed hysterically. An HOUR AND A HALF later we finally had some info. Neonatologist came in and told us that Cadence had acute respiratory distress and was intubated and that they were transferring her to Swedish down town. More sobbing hysterically from me. This was like a horrible nightmare. They promised I could see her before they transferred her. A bit later they rolled her isolette into my room and I could see her little face but that was it. She was covered in wires and tubes and I was sobbing again. I was still to numb to get up but I managed to sit up enough to see her. Then they were gone.

I spent the next 3 days in the hospital trying to get my pain under control and crying most of the time because I was worried about Cadence. I couldn't believe this was happening. Cadence was intubated for 2 days, getting IV fluids, IV antibiotics. They did and echo and her PDA was still open but otherwise her heart was normal. Her pulmonary pressures were very high in the beginning. After 2 days they were able to wean her off the inhaled nitrous oxide and the ventilator and put her on CPAP mask. She was under the bili lights for a few days also. They started tube feeds on day 3 and we worked to get her sucking on a nipple. She tired pretty easily but each day got a bit stronger. They finally weaned her to nasal cannula and eventually room air. We spent 1 day in the special care nursery after she was deemed stable enough to leave the nicu and then I convinced the nurse practioner to send us home. She is breastfeeding like a champ now. Her respiratory issues are resolved and we are just so fortunate that everything turned out OK in the end. 




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